pioneers

Unknown to many today, Clare Britton Winnicott
(1907-1984) was one of the leading British social workers of the 20th
Century. Beginning her career working with evacuated children with
special needs during World War II, she became a leader in the postwar
movement to transform child welfare services in England, directing the
first course to train social workers in child welfare practice and later
directing the Home Office’s initiatives in training child care workers.

Her wartime experiences supervising five hostels in
Oxfordshire with over 80 children who were unable to remain in ordinary
foster care has considerable resonance today. Many of these children
came from the lower socioeconomic strata of Britain's urban centers and
had minimal contact with parents endangered by Nazi bombing and overseas
in military service.

The challenges of this work under chaotic wartime
circumstances cannot be underestimated. Caseloads were large, resources
were limited, social work had no recognition in the community and
trained personnel were rare.

Many believed that adjustment would be facilitated
if the child's contact with the past was severed. Clare recalled how:

children clinging to their own clothes [were]
given an anaesthetic to enable the clothes to be removed” and many
parents rarely communicated with their children. When possible she took
a day to travel to the city and look up the parents. When she returned,
the children “would rush up and say, “Miss have you seen my mum?” “When
did you see my mum last?” And it was quite hard for them when I had to
say, “I can’t see your mum every week. Only every now and again.” But it
did awaken some parents to their own responsibilities in regard to the
children. Because I could say, “Look he’s missing you terribly. What
about a note? Give me something to take to him.” (Kanter, 2004) .

This simple intervention may seem commonsense today,
but it foreshadowed our contemporary awareness of the need to respect
the child's attachment to their parents, no matter how distant or
problematic.

Clare Winnicott’s understood that successful
residential care did not merely involve the competent physical care of
children, but also required staff to understand and acknowledge the
objective reality of children's losses and traumas. She observed that:

our real aim “to keep children alive “By keeping
children alive I am of course referring to maintaining their capacity to
feel. If there are no feelings, there is no life, there is merely
existence. All children who come our way have been through painful
experiences, and this has led many of them to clamp down on feelings and
others of them to feel angry and hostile, because this is more tolerable
than to feel loss and isolation–

To feel a sense of loss implies that something of
value, something loved, is lost, otherwise there would be no loss.
Awareness of loss therefore restores the value of that which is lost,
and can lead in time to a reinstatement of the lost person and loving
feelings in the inner life of the child. When this happens, real
memories, as opposed to fantasies, of good past experiences can come
flooding back and can be used to counteract the disappointments and
frustrations which are also part of the past (Kanter, 2004).

But while children in residential care have positive
memories of their prior life experiences, they all have experienced the
trauma of “the failure of their own homes or foster homes to tolerate
them and their difficulties any longer”. Clare noted that all children
in care:

have known the frightening experience of “things
having gone too far”. Help has been sought, and decisions made, and life
as they have known it disintegrates. The point of breakdown may have
been reached early or late in the child's experience. The home may have
disintegrated quickly at his first efforts to prove its worth, or it may
have stood a great deal up to that point and given much that the child
needs. Each child has come a different way to the point of breakdown,
and each story with its inextricable tangle of cause and effect is
peculiarly the child's own, however similar symptoms and behaviour
difficulties may appear.

But whenever children come into residential care,
even if they appear “relieved and hopeful–,

we know that they come straight from the scene of
conflict; and bring with them a deep sense of failure and guilt, which
must eventually be reached if they are to be helped. In fact, it seems
that the important function of the hostel is to help the child
eventually to reconstruct the past however bad or good it has been.

And thus ensues the all too common scenario of a
honeymoon period followed by a phase of intensive behavioural
disturbance. Clare noted that many children reach an initial stage when
they:

are sure enough of the hostel to transfer their
home difficulties into hostel life, thus “saving” their own homes and
enabling them to construct a perfect home in phantasy “on a totally
unreal level. Those of us who have worked in hostels are all familiar
with these wonderful homes which even the child from the worst
background can create, and will often actually run away to find. If the
hostel can stand firm and allow the children to work through this stage,
then gradually real relationships with hostel staff can be formed, and
slowly the child can build up ideas of home based on real experiences in
the hostel.

It is commonly said that what every child needs in
order to be good is a good home, but we know that for these difficult
children who have known repeated failure, the answer is not so simple.
They cannot enter into a good home and become part of it, until the idea
of a good home has first been created or revived in them. When the idea
is firmly established over their own personal failures, and their
phantasies of having a good home of their own are based on experiences
in the hostel, and are not subjective and idealised, then the child may
be said to be ready for a home of his own. It seems to me that the
hostel must build up this idea of home in the children, while at the
same time accepting them as they are and tolerating their difficulties.

Coming to terms with the reality of one’s prior life
traumas and disappointment is one of the major challenges of residential
care, a process eloquently illustrated in the recent film The
Antoine Fisher Story. To facilitate this process, Clare recommended
that residential staff initiate a personal talk with each new child

about his home and the facts leading up to his
leaving it. Sometimes the child would add bits to the picture, but
almost always the hostel warden was able to give information and
straighten out a good deal of confusion. The main point of this talk was
to let the child feel that the (staff) had all the facts about his life,
however unpleasant they may be, firmly held together. This undoubtedly
gave security and relieved anxiety, and was the first step towards
integrating the past and the present.

As children's services increasing adopt a simplistic
behavioural paradigm, new referrals are as likely to arrive with
checklists of problematic behaviour as comprehensive social histories.
And the here-and-now focus of many facilities may discourage staff from
attempting any historical research. Clare recalled that one adolescent
boy asked her

–to find out where my father is now. I know he was
in prison, but he should be out by this time.” As a psychiatric social
worker in the scheme, I was in most cases actually involved in the
child's initial break from home or foster home and, throughout their
stay in the hostel, the children connected me with the past and the
future, and relied on me to make the outside world real to them.
Consequently, I spent much time tracing parents, and brothers and
sisters and other relatives, and in giving the child as true a picture
as I could of the family set-up and the whereabouts of its members. This
was a difficult business, because the all too frequent lack of response
led to unhappiness and confusion for the child, but I am sure that it
had to be done.

Helping children in residential care build up an “idea of home and all that it means” and integrate this with a more
realistic view of their prior life experiences is the central tenet of
Clare Winnicott’s approach. But while sensitive to the inner experiences
of the children, she recognised that sometimes the children benefited
from the staff’s activities:

To take one example, we found that the children
benefited from some central project or activity being carried on by the
staff independently of whether or not they took part in it. We
discovered this by accident one day when the children had an unexpected
holiday. The Hostel Warden and his Assistant had planned to cut a tree
down and saw it up for the fires “and they carried on with their plan
while the children played round them in the garden. Sometimes the
children stood and watched, or helped a bit “then they ran off on their
own pursuits “and returned later “and so on. At the end of the day the
job was done, and the children enjoyed it, although they took almost no
part in it. They were unusually contented and happy that evening.

After that, for each holiday the Warden planned
some piece of work for himself and his staff to put through, and the
children played round them “sometimes helping a bit when they felt like
it “but the important thing was that the work was always put through “more quickly if they helped “but if they didn–t, it got down just the
same. This was found to be by far the most satisfactory way of dealing
with the holidays, and brought real contentment to the children.

It was this same group of children who, earlier in
the hostel’s life had asked anxiously each night “who’s going to look
after us tonight?” or “who’s going to play with us?” The emphasis had
entirely changed, and they found far greater satisfaction in fitting in
round the adults, and letting the grown-up world exist in the middle of
them “than they had when the grown-ups tried to fit in round them, and
create a childish world for them. We found them increasingly capable of
creating their own world, when they had become quite sure about the
reality of the grown-up world.

A keen observer of children in care “of their
internal world, their behavioural manisfestations and the surrounding
environment “Clare Winnicott reminds us that the essential challenges
of residential care transcend time and place, that creating an inner “home” is as important as adjusting to a given residential setting.

Sixty years later, I work with Samuel, a 14 year old
African boy who is a refugee from a civil war. Abducted by an insurgent
force at age 8, he spent three years travelling with a band of rebels,
returning home to find his father missing and his mother in a refugee
camp in a neighbouring country. Resettled with his mother and siblings
in the United States, finding “home” is still elusive as he moves from
family home to foster home to group home to detention home. The nomadic
life of the rebel army lives on as Samuel searches for a home strong
enough to “hold” him, allowing him to integrate a past as a child
soldier and a future in a new land. We are still searching for the “alive” part.

Reference

Kanter, Joel (Editor) Face to Face with Children:
The Life and Work of Clare Winnicott. Karnac, 2004.

All other citations are from the transcript of a
November 1946 transcript of a National Association of Mental Health
conference on the evacuation and its lessons.